The purpose of this study was to conduct a formative program evaluation of a school district's multisensory reading initiative. The mixed methods study involved semi-structured interviews, online survey, focus groups, document review, and analysis of extant special education student reading achievement data. Participants included elementary special education teachers of high incidence students with disabilities, elementary assistant principals, central office special education leaders, and contracted training partners. Facilitating conditions that supported multisensory reading instruction included supportive school administrators, professional learning communities, intensive initial professional development, plentiful instructional materials, and supportive central office personnel. Constraints included school master schedules, limited time for small group specialized reading instruction, inconsistent frequency and duration of multisensory instruction, reading instruction not aligned to student needs, inconsistent progress monitoring, isolation of multisensory skills without application, and inconsistent levels of administrative support. A correlation between hours of multisensory instruction and gain scores on the Developmental Reading Assessment (DRA2) showed no statistically significant relationship. Recommendations to strengthen the implementation of multisensory reading instruction included: providing additional and effective follow-up professional development, developing required progress monitoring tools, exploring assessments more aligned with multisensory instruction, fostering school-based reading PLCs, building accountability procedures that assist school administrators in supervising teacher implementation, and developing a comprehensive curriculum with more detailed lessons and pacing guides. Recommendations for continued program evaluation are included with an annual process of review, including formal summative evaluation. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]